Alcohol consumption and symptoms of depression in young adults from 20 countries.

Objective: The objective of this study was to determine whether the nonlinear association between alcohol and depressive symptoms observed in middle-aged and older men and women is present in young adults and is independent of culture, socioeconomic position, and health status.

Method: Data were from the International Health and Behaviour Survey, involving 6,932 male and 8,816 female university students ages 17-30 years from 20 countries. Alcohol consumption was assessed in terms of number of drinks per week and number of drinks per episode, and the Beck Depression Inventory (BDI) was administered. Analyses were adjusted for clustering by country.

Results: The proportion of respondents with elevated BDI scores was 19.3%, 16.3%, and 20.0% for nondrinkers, moderate drinkers, and heavy drinkers, respectively. The odds of elevated BDI scores for nondrinkers compared with moderate drinkers were 1.22 (95% confidence interval [CI]: 1.06-1.42) after adjusting for age, gender, living arrangements, socioeconomic status, and self-rated health. Analysis based on the number of alcoholic drinks consumed in the past 2 weeks indicated that, in comparison with those who consumed 5-13 drinks, the odds of elevated BDI scores for nondrinkers were 1.25 (CI: 1.02-1.53) after adjusting for the same covariates. Heavy drinkers also had higher BDI scores than moderate consumers.

Conclusions: The results suggest that the "U"-shaped association between alcohol consumption and depressive symptoms previously identified in Western countries is present in young people from a variety of cultural backgrounds. The relationship is not secondary to variations in health status, socioeconomic background, age, and gender.